WHO Knew: The Elephant in the Room

Monday, February 3, 2014 was a very strange day in London. Only the weather was predictable. A cold rain fell as a dais of scientists faced a room full of reporters in the Royal Society Library’s Special Events Room on Carlton House Terrace. With its pillared roots going back to the 1600s, the Royal Society Library had welcomed scientists from all over the world for centuries.

On this day, two scientists distinguished themselves as authors of the thick, glossy tome that was almost the biggest presence in the press briefing. Co-authors Prof. Bernard Stewart, Faculty of Medicine, University of New South Wales and Christopher Wild, PhD, Director of the World Health Organization’s (WHO) esteemed International Agency for Research on Cancer (IARC) prepared to tell the world we are on the verge of a cancer tsunami. World Cancer Report 2014 was nearly six years in the making. IARC is the cancer agency of the WHO, and a core part of their mission is to disseminate information on cancer. They gather information, frequently classify the risk level of various substances, and share that news with the world. This day the news was daunting.

Cancer rates are growing at such a rapid pace that we cannot treat our way out of this global health crisis. We must focus on prevention on a massive scale, Drs. Wild and Stewart announced to the gathering of just over 25 reporters. The human and economic catastrophe awaiting the world, with healthcare costs spiraling out of control, was described in great detail in the massive report these two men had just completed. The 650-page book, the first World Cancer Report since 2008, painted a dim picture for the world.

Reporters gathered at the press briefing heard the numbers and the implications were clear. 14,000,000 new cancer cases are being diagnosed worldwide each year, with that number expected to almost double over the next two decades to 22,000,000 new cases per year. Even the richest countries will struggle to cope with the spiraling costs of treating and caring for cancer patients. Of course the greatest burden will be borne by the lower income countries where numbers of new cases are expected to be the highest, and they are poorly equipped for the epidemic that is descending upon them. Over 60% of the global burden threatens Africa, Asia and Central and South America, where 70% of cancer deaths occur.

These were big numbers being delivered by the biggest name at IARC, Dr. Christopher Wild, the cancer agency’s director. A press release was issued worldwide, as well as to the roomful of reporters. "Despite exciting advances, the report shows that we cannot treat our way out of the cancer problem," Dr. Wild announced. "More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.” Big numbers, big news, delivered by a very big name.

Yet the largest presence in the room that rainy day in early February was unannounced and unexpected. It was not a physician, nor a reporter, nor even a human being. Looming over the presumptively- esteemed scientists delivering the presumptively-comprehensive 650-page cancer report was an immense mammal whose thick skin hung in ripples of wrinkles descending to hoofed feet. There were four of them, instead of the two that steadied both Drs. Stewart and Wild.

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